Wednesday, August 28, 2013

It's back to school time. And you know what that means! School buses are back on the roads. Morning and afternoon commutes are taking a bit longer than usual. Kids are hitting snooze on their alarm clocks as they dread leaving their warm beds in the morning to get ready for school.

It also means that August is Children's Eye Health and Safety Month: a time to bring awareness to parents to make sure their children have healthy eyes and that they are seeing well. During summer vacation, kids play outside a lot, so their visual requirements for reading and studying are probably at a low point. However, as an optometrist, I've noticed that at "back to school" time, children start complaining of not being able to see the board in the front of the room, or they're getting headaches or double vision when they read for a while.

It's important for kids to see well in order to be able to learn well. More than 80 percent of early learning is visual. What can be misinterpreted as laziness, lack of interest, of poor intelligence be actually be trouble seeing in a young child.

The most common vision problem in kids is nearsightedness. Myopia, or nearsightedness, is being able to see up close, but not far away. There are many different degrees of myopia, so a kid with mild myopia may be able to squeak by the school's vision screening exam by squinting. Other issues, such as astigmatism and farsightedness (hyperopia), can also cause blurred vision and trouble reading.

Other major issue in young children is amblyopia, which is where one eye does not develop properly, resulting in poor vision compared to the fellow eye. This happens when one eye has an eye turn or when one eye has a high prescription compared to the other eye.

Everyone has two eyes, and people use their two eyes, together, all of the time. So if one eye is blurry, it can easily be ignored or overlooked because of the great vision of the better seeing eye. This is why it is important for every child to get an eye exam, EVEN IF THEY ARE NOT COMPLAINING OF BLURRED VISION, because amblyopia is treatable, but only if it is diagnosed at an early age and treated appropriately.

Obviously, as an astute parent, if your child is obviously complaining of blurred vision, it's easy to make the decision to bring them in for an eye exam. However, the parent should also look to see if the child has any of the following symptoms:

Frequent eye rubbing or blinking

Squinting

Headaches

Covering one eye

Short attention span

Avoiding reading assignments or holding reading materials close to the face

A turned eye

Double vision

Losing place when reading

Difficulty with reading retention

These symptoms can also be the result of trouble with eye
focusing, eye tracking and eye coordination problems, which can all affect school
performance.

According to the American Optometric Association, many children are mislabeled as having Attention Deficit Hyperactivity Disorder (ADHD), when they many actually have an undiagnosed vision problem. Vision is an important component in learning. A child with blurred vision or focusing problems doesn't know any better because they don't have the perspective of perfect functioning visual system.

So, that's children's vision in a nutshell. If there are any visual concerns with your child, make sure to bring them in for an eye exam sooner than later.

Sincerely,
Dr. Weaver

Ps. And check out our Merchandiser advertising over the next month for our "Back To School" savings for eyeglasses.

Friday, July 26, 2013

I seems that my blog posts have been sporadic lately, but there is good reason for that. Things have been very busy this past year at the practice. If you remember, I opened Weaver Eye Care Associates in January of 2011, now almost two and a half years ago! With any new cold start practice, business is a snails pace, which gave me plenty of time to write blog articles.

The business grew 20% in the following year, 2012. Empty spaces on the schedule were less, and more eyeglasses and contact lenses were ordered. I fly a banner in front of my office welcoming new patients. I send out practice emails to those who are lucky enough to have already visited the office, keeping you updated on practice specials and news. I advertise mostly through postcard mailers, which seems better than newspaper advertisements. The ABSOLUTE BEST advertisement, though, is the word of mouth referrals. Despite all of this, there are many, many people who still do not know that there is an eye doctor in Bernville...

So far, in 2013, the business is growing and it's looking like at least 25% growth from 2012 so far, which could be higher or lower than that depending on the rest of the year. The positive thing about this is that the practice is heading in the right direction. So, I'd like to extend a BIG THANK YOU to all of you who are satisfied patients, as well as friends and family that support me.

Now, onto the vision topic of the day...

I have patients that come into my office sometimes with a Pennsylvania Driver's License examination form. Mostly, patients get this form in the mail randomly from PennDOT to ensure that the driver's vision is "up to par" so that they are legal to drive.

So, what is legal to drive? If you can see 20/40 or better with both eyes, you are legal to drive. If you can get this without glasses or contact lenses, you do not need a "corrective lenses" restriction on your license. If you can not see 20/40 without glasses or contacts, but the glasses or contact lenses allow you to see better than 20/40, you get the "corrective lenses" restrictions, meaning you must wear your eyeglasses or contact lenses to drive. Otherwise, you will get in trouble if you get pulled over.

If your vision is not correctable to 20/40 with both eyes, but can be 20/70 or better, you may drive ONLY during daylight hours. If your vision is not correctable to 20/70 but is better than 20/100, you also have to take and successfully pass a driver's examination, you are limited to certain roads (no highways), can only drive passenger vehicles (no motorcycles), are limited to a certain radius around your house, AND must get approval from the eye doctor.

At least they ended up at the right place...

If your vision is not correctable to 20/100 with both eyes (that's just two lines down from the big E, FYI), you are out of luck. You are not legal to drive.

In addition, you must have good peripheral vision as well, as this can restrict your license.

From my experience, most PA Driver's license vision exam forms that I fill out is just a precautionary measure. Those patients are already legal to drive, and they can continue to do so even after seeing me for my professional evaluation. However, there are times where a patient's vision has become so poor that they should not be driving, and when I tell them that fact, their response is usually: "I'm fine. It's just a little blurry." This is when they can only make out the big E with both eyes, 20/400.

She's not even looking through her glasses!

The issues are eye conditions or prescription changes that cause visual blur. The blurred vision changes can be sudden, but usually it's such a slow, gradual change that the patient adapts to the blur as it occurs, kind of like the 6-year-old in Kindergarten or First Grade that sits in front of the classroom because he/she can't read the board from the back of the room. The kid doesn't know he/she needs glasses. The child just adapts.

The purpose of the PA Driver's License exam form isn't to ostracize elderly drivers, even though there is humor revolving around that topic (see photo above). It's to make driving safe and remind people to get their eyes examined more than once every 20 years. Many times, a patient may just need a change in their eyeglasses prescription to get him/her back to legal driving status. Or, maybe there is a huge cataract causing the problems and the patient needs cataract surgery to give the best vision to him/her in numerous years. Or, it's possible the patient has glaucoma and doesn't know it...they've permanently lost his/her peripheral vision and are not legal to drive, but the condition is still caught by the optometrist so the patient can undergo treatment to preserve the remaining vision so complete blindness doesn't occur.

So, I hope all of you are driving safe. And if you're having any visual difficulty driving, like in the rain or at night, your vision may not be optimal. It would probably be safer for you and other drivers and pedestrians to get an eye exam and see what the heck is going on...so you don't have to cringe when you get that dreaded letter in the mail from PennDOT.

Sincerely,
Dr. Weaver

Ps. Oh! And I think the Berks Mont newspapers Blue Ribbon Award voting is happening soon. Don't forget to vote (for us). 2012 winners in Eye Care last year. Hope we get two years in a row!

Wednesday, May 8, 2013

How are your eyes doing? Are they itchy, scratchy, watering, red, painful, blurred, irritating, swollen, sensitive? And they've been like that for HOW LONG?!

Yes, it seems that self-medicated remedies are the way to go to save a trip to the doctor. Have a little muscle ache = use some Tylenol. Have a little headache = use some Advil. Have some sinus issues = use some Sudafed.

If you walk down the isles in the pharmacy, you can see how each section is inundated with opportunities for self-prescribed healing...and it can be confusing. This medication has this active ingredient, and that medication has that active ingredient, but this medication has this active ingredient AND that active ingredient. Do I take the medication with the cough suppressant when I'm not coughing? Do I take the allergy medication if I'm not sneezing? And on and on and on...

The same thing with OTC (over-the-counter) eye remedies. There are tons of options for itchy. There are tons of options for dry eye. There are TONS of options for itchy AND dry eyes. But, do they all work?

Unless you get the advice from your eye doctor on what OTC medications to use, you're really just guessing. There are certain OTC medications that used to be prescription medications that work extremely well for eye allergies, and there are some "homeopathic" eyedrops out there that are just plain money wasters.

But you're not alone...millions and millions of people purchase OTC medications to save that trip to the eye doctor. Like I said, there's nothing wrong with that...as long as there's nothing wrong with your eyes.

When I say "nothing wrong," I mean "nothing majorly, or severely wrong." Honestly, certain conditions are self-limiting, such as allergies or dryness. These conditions are due to the time of the year, or the working environment, or the air quality, etc. They may go away on their own, and the OTC medications or lubricating drops will do the trick to alleviate or remedy the problem.

However, if there is blurred vision and you think it's from allergies and it's not getting better, stays the same or gets worse...it's probably something else other than allergies. If your eye is red and painful and you stopped wearing your contacts (the right thing to do) and it still hasn't improved with those over-the-counter artificial teardrops, it's probably not dry eye.

So here's the list again (it's not comprehensive, just a short list as a guide). If your eye experiences:

Friday, January 25, 2013

Congratulations to the winners of the Weaver Eye Care Associates First Grade Poster Contest. All fifth graders in the Tulpehocken School District entered, and there were amazingly original entries...but I could only pick a few to take the top prizes. First place won a check for $50, second place got $25 and third place got $15. The posters are also hung up in the waiting room of our office! I'm not including the names in case there's a privacy issue, but you know who you are...CONGRATULATIONS!

FIRST PLACE!!!

SECOND PLACE!!!

THIRD PLACE!!!

Good job all around guys and gals. Keep up the good work and tell your fourth grade friends to think of good ideas for next year.

Tuesday, January 22, 2013

I've written a blog article before about the confusion involved with the various lens materials and coatings to choose from when purchasing eyeglasses (found here). One of these choices is polycarbonate, the most shatter resistant lens material. There is another lens material called Trivex with the same properties. It is technically not shatter-proof, but it resists impact better than other lenses (plastic and glass).

I had a patient come into the office last week telling me about an eye injury that took place a little while ago that caused him to go to the emergency room. He gave me permission to use his story in order to educate others about what happened to him. Here's what happened:

The patient was moving a piece of drywall into his attic. The entry to the attic was through a drop-down door from the ceiling, with the attached ladder. In order for the piece of drywall to fit through the space, the patient had to remove the springs from the ladder to allow a wider opening. After the patient successfully moved the drywall, the patient replaced the one end of the spring and attached it to a pin. As the patient was reaching for a nut to screw down the end of the spring to the pin, the spring let loose and whapped the patient in his left eye! Fortunately, the patient was wearing eyeglasses with polycarbonate lenses.

Here is what the frame and lens looked liked. The frame was completely mangled, and the patient said the lens was found later on the floor several feet away. Just the force of the impact created an indentation into the lens and bent the lens edge.

(The mangled frames.)

(You can see the indentation into the lens from the force of the spring.)

(The edge of the lens from the impact. You can see how the force physically dented the lens.)

The patient was rushed to the ER with a nose fracture, and bleeding and inflammation in the eye, as well as bruising and swelling to his eyelids. When he came into my office to tell the story, he mentioned that the bleeding and inflammation had almost completely resolved, but that the vision wasn't quite the same as the non-impacted eye. However, I told him that if he would have chosen regular plastic lenses for his eyeglasses, he probably would have lost the eye.

So, the lesson here is...consider switching to polycarbonate lenses when purchasing your next pair of eyeglasses. The doctor makes eyeglasses recommendations for good reason. I am very happy that this patient of mine followed through on my recommendation.

Wednesday, January 2, 2013

First of all, Happy New Year! I'm writing this blog post from my underground bunker, just in case the Mayans were off by a couple of weeks. I am hopeful the apocalypse will not occur anytime soon, but to be sure, I'll just stay down here a couple of more days with my crates of bottled water and rations of Twinkies and astronaut food, doing eye exams by candlelight...

Well, as it is evident, no one can see the future, but you can see the present. But can you see the present CLEARLY? Or is it a blurry, headache, squinty mess that makes you avoid or quit reading, using a computer, watching television, or any other visual task?

However, clear vision is only a part of the equation. You may be able to see "Eagle Eye better than 20/20 vision" without eyeglasses or contact lenses, but can you be absolutely sure there isn't a suspicious looking growth the size of Mount Vesuvius in the peripheral retina of your right eye? My personal recommendation is an annual eye exam to not only check vision, but to check the health of the eyes for cataracts, glaucoma, macular degeneration, and a plethora of non-symptomatic eye diseases. For example:

1) Cataracts = usually an age-related condition. The older you get, the higher the risk of cataract formation. Cataract formation due to age is typically a slow, gradual change. Also, changes may occur in one eye more than the other, causing vision changes to go unnoticed. These changes include: blurred vision, increased glare and light sensitivity, difficulty driving at night or reading in dim illumination (restaurants), and a diminution of colors. Researchers have linked nutrients such as lutein/zeaxanthin, vitamin C, vitamin E and zinc to reducing the risk of eye diseases such as cataracts.

2) Glaucoma = also an age-related condition, but can happen at any age. Glaucoma is irreversible damage to the optic nerve causing vision loss that is related to high pressures in the eyes. So, the older you get and the higher the intraocular pressure, the higher the risk of developing glaucoma. A family history of glaucoma is also a risk factor. Glaucoma causes vision loss to the peripheral vision first, and then begins to impact the central vision in mid- to late stages of glaucoma. Any vision loss is not recoverable, so treating glaucoma in its early stages is important to prevent blindness. The only way to tell is if you have high intraocular pressures is to get them measured at an eye exam: the air puff OR the yellow numbing drop combined with the blue light. And if there is a high suspicion of glaucoma, your eye doctor will recommend additional medical testing to check for evidence if glaucoma is taking place: computerized peripheral visual field test (sensitive test for peripheral visual field changes), optic nerve photography and/or optic nerve scanning laser tomography (documents changes to the optic nerve appearance over time), corneal pachymetry (front of the eye thickness), gonioscopy (are the drainage angles in the eye open?) and repeat intraocular pressure measurements (measurements can vary throughout the day). YES, it's pretty involved!

3) Macular degeneration = again, an age-related condition. This condition causes central vision loss due to structural damage to the macular region of the retina, the very center most portion responsible for fine, central visual acuity. There is a "dry" and "wet" form of the disease, and there are varying levels of severity. Unfortunately, both forms are bad to have, and the condition only progresses causing vision deterioration as time goes on. Blurred vision may be the start of this disease. So, if left undiagnosed, it can get shot to H-E- double hockey sticks in a hurry. Again, at least yearly exams and macula photography or macular tomography is important to document change. Multivitamins formulated for macular degeneration have been shown to slow down the advanced stages of macular degeneration. Oh, and AVOID SMOKING! Smoking quadruples the risk of developing macular degeneration!

4) Eye lesions = can happen anywhere and anytime. The develop of benign and malignant lesions are usually related to lengthy exposure to UV rays (outdoors, tanning booths). They can happen on the eyelid, the inner part of the eyelid, the white part of the eye, the colored part of the eye (iris) and even the back of the eye (choroidal nevus). The nevi (freckles) typically occur on the iris and the choroid. Just like suspicious-looking freckles on the skin checked at regular intervals for changes in size, shape, and color, so should any suspicious areas of the eye be checked.

Dilating the eyes is important to make sure the entire eyeball is healthy, so that the eye doctor can look into your eye with a wide-open pupil that doesn't constrict when the light is shined into it. If you've never had your eyes dilated, let me tell ya', it's loads of fun! Actually, I'm biased. The majority of non-eye doctors would easily admit they'd rather have a tooth pulled sans novocaine...but dilating the eyes are important to make sure that Mount Saint Helens sized retinal lesion (yes, it's getting bigger!) isn't happening at all.

The take home message is that not all eye diseases are created equal. Some diseases are not a big deal, some cause vision loss that is not detectable by the patient until it's too late, and some diseases may be a sign of more serious conditions, such as cancer.

If you've never had the dilating drops at wherever you get your eyes examined, do your eyes and yourself a favor and go somewhere that does. You only get one set of eyes, and you want them to outlast your body so that you can see everything as clear as possible until your last day on earth (which may, or may not, be caused by an apocalyptic event).

Sincerely,
Dr. Weaver

Ps. And in case you don't know where we are, below is a picture of our sign visible from Rt. 183 (across the street from Boyer's Food Market). Drive into the parking lot and come on in! Welcoming New Patients!

MISSION STATEMENT: Weaver Eye Care Associates is dedicated to become the reputable leader in eye health and optical services in the community and Berks County, while striving to satisfy all patients’ needs; to establish a growing and loyal patient population that is fostered with excellent customer and public relations; to provide outstanding patient care by utilizing the latest technology in optometry equipment and educational services.